Cardiovascular Pharmacology

Question 1

Remember:

• Alpha antagonists
• Alpha agonists
• Beta antagonists (Beta blockers)
• Muscarinic antagonist

Question 2

Direct Renin Inhibitors (Example, MOA, Indication, CI, AEs)

Answer 2

Example: Aliskiren

MOA: Inhibits renin enzymes –> dec. Ang I –> vasodilation

Indications: Hypertension

CI: pregnancy

AE’s: N/A

Question 3

ACE Inhibitors (Example, MOA, Indication, CI, AEs)

Answer 3

Example: Enalapril

MOA:
- Inhibits ACE enzymes –> dec. Ang II–> vasodilation
- dec. bradykinin degradation –> inc. [bradykinin] –> bronchoconstriction

Indications: Hypertension, Heart Failure, Myocardial infarction, Diabetic nephropathy

CI: pregnancy

AE’s: Cough, angioedema

Question 4

AT1 Receptor Blocks/ARBs (Example, MOA, Indication, CI, AEs)

Answer 4

Example: Losartan

MOA: antagonists at AT1 receptors –> vasodilation (but still increases [renin])

Indications: Hypertension, Heart Failure, Myocardial infarction, Diabetic nephropathy
*Evidence is less well known

CI: pregnancy

AE’s: N/A

Question 5

Calcium Channel Blockers - DHP (Example, MOA, Indication, AEs)

Answer 5

Example: Amlodipine

MOA: Blocks LTCCs on VASCULAR SM

Indications: Hypertension (first line), Angina Pectoris, Some cardiac arrhythmias

AE’s: Hypotension, Headache, Peripheral edema

Question 6

Calcium Channel Blockers - non-DHP (Example, MOA, Indication, AEs)

Answer 6

Example: Verapamil

MOA: Blocks LTCCs on HEART

Indications: Hypertension, Angina Pectoris, Some cardiac arrhythmias

AE’s: Bradycardia, AV block, Cardiac depression, heart failure, Constipation (mainly verapamil)

Question 7

NO Donors - Nitroglycerin (MOA, Indication, AEs)

Answer 7

[PRODRUG]

MOA: Release NO → activate GC → ↑cGMP → vasodilation

Indications: Angina Pectoris

AE’s: Hypotension, Headache, Flushing, Reflex tachycardia, Tolerance (needs to include NO-free intervals)

Question 8

NO Donors - Nitroprusside (MOA, Indication, AEs)

Answer 8

MOA: Release NO → activate GC → ↑cGMP → vasodilation

Indications: Hypertensive emergencies, Acute HF, Production of controlled hypotension

AE’s: Hypotension, Cyanide toxicity

Question 9

PDE5 Inhibitor (Example, MOA, Indication, CI, AEs)

Answer 9

Example: Sildenafil

MOA: Inhibits PDE5 → ↓ cGMP degradation → ↑ cGMP → vasodilation

Indications: Erectile dysfunction, Pulmonary HTN

CI: alpha antagonists, other organic nitrates

AE’s: Headache, Flushing, Back pain, Vision loss / changes in color, Hearing loss

Question 10

Cardiac Glycoside (Example, MOA, Indication, AEs)

Answer 10

Example: Digoxin

MOA:
- Inhibits Na+-K+ ATPase → ↑IS

• ↑PANS + ↓SANS to heart → ↓ AV conduction

Indications: Adjunct therapy in Heart Failure, Cardiac arrhythmias

AE’s: GI Effects (N/V/anorexia), Cardiac arrhythmias, VERY LOW therapeutic index

Question 11

Sympathomimetic Amines (Example, MOA, Indication, AEs)

Answer 11

Example: Dobutamine

MOA: Β1 agonist → ↑ IS

Indications: Short term therapy in acute HF

AE’s: tachycardia